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0 UNDERGROUND TANK INSPECTION RECORD <br />NEW TANK INSTALLATION <br />SITE NAME Z2 (01 L INSPECTOR'S NAME <br />—ADDRESS 1403 C(-UF� BLVD9 CITY 5'l X_61'n21P g52.n—�-- <br />CONTRACTOR: NAME ► ' aZn L(j W QS -V= 8 ki PHONE_— <br />OWNER: NAME -5.F. O i L PHONE <br />//G� <br />DIS <br />INSPECTOR'S <br />INITIAL INSPECTION <br />i. UL numbers 3�G5OA tank size ��0 00� �`^'vo <br />DATE <br />kPPROVED <br />PPROVED <br />INITIALS <br />. Tank tested upon delivery [Holiday (plasteel) or air at 5 PSI (FRP)) <br />nqi <br />3. Overfill protection Installed, describe: ! 1 _ ati !� <br />ITEM OR EQUIPMENT INSPECTED <br />l <br />4. Unused tank opening sealed and cathodically protected. nU Ud10SP 7 <br />1. Fees paid <br />'L it <br />l <br />------ <br />6. Monitoring ports in place and brought to grade. (lockable weather proof covers) <br />. Plans Approved <br />//G� <br />V <br />(PING STAGE INSPECTION 19- �j `7�,/ 2 o.: 0-,, -, <br />1. Pressure test of piping. (Primary and Secondary (NEPA 30)) <br />INITIAL INSPECTION <br />i. UL numbers 3�G5OA tank size ��0 00� �`^'vo <br />Al <br />er� <br />2. Ball float valves installed. <br />. Tank tested upon delivery [Holiday (plasteel) or air at 5 PSI (FRP)) <br />nqi <br />3. Overfill protection Installed, describe: ! 1 _ ati !� <br />. Visual inspection of secondary containment. <br />l <br />4. Unused tank opening sealed and cathodically protected. nU Ud10SP 7 <br />. Tank appropriately placed with approved backfill. <br />//G� <br />V <br />(PING STAGE INSPECTION 19- �j `7�,/ 2 o.: 0-,, -, <br />1. Pressure test of piping. (Primary and Secondary (NEPA 30)) <br />FINAL INSPECTION <br />1. Precision test successfully completed and hard copies received. (NFPA 329) <br />Al <br />er� <br />2. Ball float valves installed. <br />2. Spill protection at fill pipe. <br />vy r� <br />qv � 1\1 <br />3. Overfill protection Installed, describe: ! 1 _ ati !� <br />3. Performance test of overfill protection system. <br />(2 <br />4. Unused tank opening sealed and cathodically protected. nU Ud10SP 7 <br />U) V <br />5. Visual inspection of secondary containment on piping. °-P kt <br />l <br />------ <br />6. Monitoring ports in place and brought to grade. (lockable weather proof covers) <br />Q <br />7. Fill and vent piping brought to grade. <br />6. Permit to operate application complete. <br />8. Product line leak detector in place. (Hard wired) <br />7. Acceptable recordk6eping system. <br />Ali r� <br />9. Approved tank leak monitoring device installed. <br />�✓✓ <br />10. All galvanized piping and fittings properly wrapped. 7 <br />11' Pressure decay test on complete tank and product delivery system. <br />//G� <br />�j( <br />q V "� <br />FINAL INSPECTION <br />1. Precision test successfully completed and hard copies received. (NFPA 329) <br />Al <br />2. Spill protection at fill pipe. <br />Cn((% <br />3. Performance test of overfill protection system. <br />(2 <br />4. Performance test of product line teak detector. (Hard wired) <br />/ Gil <br />l <br />l✓ �� <br />5. Performance test of continuous monitoring system(s) on tank (s) <br />6. Permit to operate application complete. <br />7. Acceptable recordk6eping system. <br />Comments: <br />EN 23 006 10/89 _- --- <br />